Psychology Commons^™

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …

Disparities Between Native Americans And White Individuals In Trajectories Of Community Participation Over The 5 Years After Traumatic Brain Injury, Jack Watson

Theses and Dissertations

Traumatic brain injury (TBI) disproportionately affects minoritized populations within the U.S., especially Native Americans who are more likely to experience a more severe or fatal TBI than White individuals. The current study used a subsample of 63 Native Americans with TBI from the TBI Model Systems (TBIMS) database matched by age, sex, and injury severity to 63 White individuals to examine disparities in community participation, as measured by the Participation Assessment with Recombined Tools—Objective (PART-O), over the five years following TBI. Analysis of variance (ANOVA) and chi-square tests revealed Native Americans were less likely to be employed prior to injury, …

Evaluating The Role Of Interoceptive Awareness In Insomnia And Across The Sleep Health Spectrum, Lara Lobrutto

Theses and Dissertations

Interoceptive awareness, characterized by a non-judgmental and trusting attitude towards body sensations, is an understudied construct that is implicated in sleep and health outcomes. Interoceptive awareness is cultivated via contemplative and mindfulness-based practices. Given that it may be utilized to reduce pre-sleep arousal, which is a key mechanism in insomnia, interoceptive awareness is posited to be a protective factor for sleep health. A cross-sectional study was conducted among undergraduate university students (N = 420) in the Mid-Atlantic region of the United States to assess the association between interoceptive awareness and sleep outcomes. Participants received a survey link and completed …

The Impact Of A Parent-Only Pediatric Obesity Intervention Program On Quality Of Life In Racially Diverse Children, Taylor Vashro

Theses and Dissertations

Pediatric obesity has been associated with significant decrements in pediatric quality of life (QOL) comparable with severe pediatric diseases such as cancer. Parenting interventions have yielded health benefits for children with obesity; however, few studies have investigated the impact of parent-focused interventions on QOL in children with overweight and obesity. This study investigated the impact of a 6-week intensive parenting intervention program on the QOL of 5-12 year old, predominantly Black children with overweight and obesity. Parents were randomized into either the parenting intervention (NOURISH+) or a control group, and QOL, as well as variables related to child and parenting …

Examining Allostatic Load As A Biological Mechanism Linking Childhood Adversity And Pediatric Pain, Angela Pascale

Theses and Dissertations

Despite a strong literature base relating childhood adversity to pain, the biological mechanisms underlying these associations remain unclear. Theoretical and preliminary empirical evidence supports allostatic load as a potential biological mechanism, though prior studies investigating associations between childhood adversity and elevated allostatic load and/or between elevated allostatic load and poorer pain outcomes have primarily focused on adult populations and individual allostatic load indicators rather than a comprehensive index. Thus, the current study built upon prior literature by testing longitudinal relationships between childhood adversity and multiple biological indicators spanning across physiological systems (i.e., comprehensive allostatic load index) and pediatric pain outcomes …

How Do Cultural Norms Shape Healthy Eating In African Americans? The Role Of Cultural Congruence And Mindsets Of Health In Healthy Eating Intentions Among African American College Students, Danyel Smith

Theses and Dissertations

Targeting dietary behaviors is a predominant strategy to reduce rates of obesity among African Americans, across the lifespan. Notably, dietary behaviors are shaped by social, cultural and environmental affordances. This study integrated Theory of planned behavior (TPB), identity-based motivation, and mindset theory to unearth cultural mechanisms that inform motivations to eat healthy among African American college students. This project employed a cross-sectional (Study 1) and experimental design (Study 2) to contextualize the antecedents of intentions to eat healthy among African American college students. Recruitment occurred via university-wide digital channels. Eligible participants: were 18+ years; Black/African American; were undergraduate students; and …

Sleep And Health Behaviors In A Safety-Net Primary Care Setting, Sahar Sabet

Theses and Dissertations

Nearly half of all premature deaths in the United States are attributable to preventable and modifiable health risk behaviors. For decades, the leading behavioral health contributors to morbidity and mortality are tobacco use, physical inactivity, and alcohol consumption. Medication adherence is a relatively less studied yet critical interrelated health behavior that is tied to health and treatment outcomes. Sleep, an important pillar of health, is a daily and modifiable behavior that shows promise as a health behavior facilitator. Better understanding the dynamics of these modifiable health behaviors is essential for the improvement of health promotion, particularly among underserved populations (e.g., …

Addressing Death Distress In Caregivers Of Patients With Malignant Glioma, Kelcie D. Willis

Theses and Dissertations

The field of psychosocial oncology seeks to improve the quality of life of patients and families affected by cancer. This task becomes increasingly important when there are limited, non-curative treatment options, a high probability of recurrence, and rapid functional decline, such as in the case of a malignant glioma (MG). Indeed, the diagnosis of a MG is associated with negative sequalae that often translates to higher caregiver burden. Caregivers—who must manage the functional decline of the patient, changes within the family, and a complicated medical system—often feel overwhelmed, isolated, and ill-equipped to handle these myriad responsibilities. While they also report …

Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason

Theses and Dissertations

Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …

Factors Associated With College Students' Intention To Use Telehealth For Primary Care, Conor Duffy

Theses and Dissertations

College students are less likely than the general population to have a regular primary care provider and engage in routine health visits. Recent research provides evidence that telehealth is a convenient alternative to in-person primary care and that college students are comfortable using this technology, suggesting that telehealth has the potential to mitigate this disparity. However, little research has examined which factors are associated with college students’ intention to use telehealth and attitudes toward telehealth specifically in the primary care context. The overarching goal of this study was to address this gap in the literature and identify factors associated with …

Profiles Of Family Functioning In Pediatric Hematology-Oncology Patients: Longitudinal Associations With Child Well-Being, Sydney Sumrall

Theses and Dissertations

This study aims to assess 1) patterns of family functioning and 2) longitudinal associations between family functioning patterns and well-being in a vulnerable cohort of children with chronic illness. Caregivers of hematology (16.4%) and oncology (83.6%) patients ages 7-20 (N=55; M_age = 13.3 [SD = 2.7]; 52.7% female; 45.5% non-Latinx White, 38.2% Black or African American, 12.7% Latinx, 1.8% Asian, and 1.8% multi-racial,) reported on family functioning via the Family Assessment Device. Cluster analyses identified three mutually exclusive clusters: one high adaptive group, one moderate adaptive group, and one maladaptive group. Group membership was not significantly …

“Trans Broken Arm Syndrome”: Examining Causal Antecedents Of Gender-Related Medical Misattribution And Invasive Questioning In An Analogous Healthcare Setting Through The Lens Of Person Perception, Catherine Wall

Theses and Dissertations

Transgender individuals face particular challenges when interacting with a cisgender focused medical system. Gender-related medical misattribution and invasive questioning (GRMMIQ), colloquially known by the tongue-in-cheek named “trans broken arm syndrome,” is a form of medical discrimination wherein a healthcare provider assumes that a transgender patient’s medical complaints, regardless of origin, result from their gender identity or medical transition. Previous research has suggested that this, and other forms of identity-related discrimination both in and outside of healthcare, might be understood either using a top-down approach focused on stereotypes founded in schema, or a bottom-up approach examining perceived typicality. One additional theory, …

Recovery Sleepers: A Pilot Study Of A Sleep Health Intervention For College Students In Recovery From Substance Use Disorder, Morgan P. Reid

Theses and Dissertations

There is an increasing number of students in recovery from substance use disorder (SUD) on college campuses, and collegiate recovery programs have been designed to support students’ recovery and global health needs. However, little research has focused on interventions that can promote health outcomes within this population. Chronic substance misuse can have lingering, negative effects on sleep even after sustained remission; thus, the present paper describes a pilot study of Recovery Sleepers, a sleep health promotion intervention rooted in self-determination theory for college students in recovery from SUD. Study aims were to examine the feasibility, acceptability, and fidelity of the …

A Technology-Based, Mixed Methods Approach To Examining The Psychosocial Determinants Of Maternal Health Disparities, Hannah M. Ming

Theses and Dissertations

Background: Exposure to racism and discrimination in the U.S. increases Black women’s risk for experiencing maternal health disparities. Additionally, racism and discrimination affect maternal psychosocial well-being, creating evidence for a biopsychosocial relationship between racism and maternal health outcomes. However, current research does not define the psychosocial Black maternal self well. Given the dynamic relationship between racism, psychosocial well-being, and Black maternal health outcomes, research must comprehensively examine the Black maternal self. The operationalization of a comprehensive construct for Black maternal psychosocial well-being can improve understanding of the relationship between racism, psychosocial well-being, and Black maternal health outcomes.

Purpose: …

The Examination Of Health Care System Distrust As A Barrier To Utilization And Engagement Of Preventive Services In The Health Care System In Black Emerging Adults, With A Special Focus On Insurance Status And Usual Source Of Care., Alexandra Wynn

Theses and Dissertations

Health care system distrust is a well-known barrier to health utilization and engagement in older African Americans. However, it has not been explored in Black emerging adults, individuals 18- 26. It is important to explore the social and psychological effects of systemic barriers, such as health care system distrust, in this developmental period as emerging adults undergo unique demographic shifts, changes in sense of self, and identity exploration. Due to emerging adulthood being an exploratory and challenging transitionary phase, emerging adults have an increased susceptibility to preventable morbidity and mortality issues and decreased access to important preventive services. Thus, health …

Black Hearts Matter: A Comparative Study Of Sociodemographic, Clinical, And Psychosocial Characteristics In Black And White Persons With Heart Failure, Hannah M Anderson Hughes

Theses and Dissertations

Heart failure (HF) is a chronic, progressive, debilitating illness that disproportionately affects Black individuals, often leading to poor quality of life (QOL). Various sociodemographic, clinical, and psychological characteristics are related to QOL in patients with HF. Because most studies do not include representative Black samples or report findings from racial subgroup analyses, these relationships and any existing racial differences are not well understood. The purpose of this descriptive, comparative study was to explore the relationships among sociodemographic, clinical, and psychological characteristics and QOL in patients with HF and to determine if there were racial differences between Black and White individuals. …

Empowerment In Adolescents And Young Adults With Cystic Fibrosis, Rachel Holder

Theses and Dissertations

Adolescence and young adulthood is a pivotal time for individuals with cystic fibrosis (CF) that is characterized by increased self-management, transition to adult-oriented healthcare, and often a decline in treatment adherence and health-related quality of life (HRQoL) (Abbott et al., 2015; Modi et al., 2008). The literature regarding which factors are important for readiness to transition, treatment adherence, and HRQoL is limited in this population. However, empowerment has emerged as a salient construct in other disease groups (Acuña Mora et al., 2019; Burström et al., 2019; Kaal et al., 2017). As such, this thesis determined the convergent validity of the …

Characterizing The Patterns, Predictors, And Processes Involved In Recovery From Substance Use Disorders, Rebecca L. Smith

Theses and Dissertations

Alcohol and drug use disorders are associated with significant cost to individuals, families, and society.Approximately 40-75% of affected individuals remit from alcohol use disorders (AUD). Although the development of AUD is well studied, recovery from AUD and factors that contribute to recovery are not as well characterized. With the definition of recovery evolving towards a process rather than an outcome, there is a need to better understand psychosocial functioning and quality of life among individuals at different points in their recovery journeys. Concurrently, additional research is needed to understand the interplay between sources of recovery capital, individual differences in risk …

Investigating The Potential Causal Relationship Between Free Will Belief And Well-Being, Courtney J. Alderson

Theses and Dissertations

This multi-study dissertation had four primary aims. My first was to add to the evidence base indicating a positive association between free will belief (FWB) and subjective well-being (SWB). My second aim was to develop a measure to assess the FWB theme referred to as the principle of alternate possibilities (PAP). To achieve the first two aims, I conducted two cross-sectional studies to further establish the FWB-SWB association and start the development and assessment of a new PAP FWB measure. In the first study (N=995), I hypothesized that an EFA of the new PAP items would produce at least a …

Predicting Medication Adherence Patterns During The Maintenance Phase Of Treatment For Pediatric Leukemia And Lymphoma: A Model Of Individual- And Family-Level Factors, Stephanie M. Romo

Theses and Dissertations

Adherence during the maintenance phase of pediatric cancer treatment is critical to prevent relapse and ensure long-term, event-free survival. Yet, little research has been done to examine individual- and family-level factors that may relate to adherence during the maintenance phase of treatment, particularly among Latinx patients. This is surprising given findings demonstrating that children who miss more than 5% of their prescribed oral chemotherapy medicine, most commonly 6-mercaptopurine (6MP), are 2.5-2.7 times more likely to relapse than children who take 95% or more of their prescribed 6MP. Pediatric cancer patients face unique adherence challenges given the importance of family involvement …

Perceived Discrimination And Mental Health Outcomes In College Students: The Mediating Role Of Preventive Health Behaviors And Social Support, Sarah C M Morton

Theses and Dissertations

Perceived discrimination has been linked to adverse mental health outcomes, increased risk-taking behaviors, and poor engagement in health promoting behaviors. College students may be especially susceptible to negative mental health outcomes associated with discrimination due to the unique stressors faced by young adults (e.g., prolonged transition to adulthood, onset of mental health disorders, changes in social support). The current study examined the mediating and moderating roles of health behaviors and social support on the association between perceived discrimination and mental health outcomes (e.g., anxiety, depression, suicidality) in college students. A total of 709 college students (42.8% White; 72.2% female; 30.2% …

Shared Decision Making In Adolescence: The Role Of Race And Health Status, Mona L. Quarless

Theses and Dissertations

Youth participation in Shared Decision Making (SDM) is still a novel clinical practice with unique considerations. Moreover, though SDM has been touted as an effective model for patient-centered care it has largely been underutilized and under-researched in Black and Latinx adolescent populations. The current study examined the association of health factors that may relate to Black and Latinx adolescents, their families, and HCPs engaging in SDM. Specifically, I examined within-group racial differences in relation to health conditions (i.e., pain, obesity, mental health status) and SDM during adolescence. Measures of adolescent chronic pain, BMI status (overweight/obese), mental health symptoms (depression/anxiety), SDM …

The Abuse Liability Profile Of An Unflavored, Sucralose-Sweetened, Electronic Cigarette In Combustible Cigarette Smokers, Sarah F. Maloney

Theses and Dissertations

The purpose of this study was to examine the effects of sucralose and nicotine in otherwise unflavored PG/VG ECIG liquid solutions, via a 30-watt ECIG, using multiple measures predictive of abuse liability to provide a basic understanding of the effects of sweeteners and perceived sweetness on ECIG abuse liability in reference to combustible cigarettes. Fourteen dependent smokers completed five independent study sessions that were within-subject, Latin-square ordered, and were identical in regards to all aspects but the product used. In each session, participants were given either their own brand of cigarettes or one of the four ECIG conditions: 0 mg/mL …

E-Cigarette Use And Perceptions Among Adolescents With Attention-Deficit/Hyperactivity Disorder: The Role Of Parental Messages About Tobacco, Mayra S. Ramos

Theses and Dissertations

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of using e-cigarettes compared to their neurotypical peers. Parent-adolescent communication about tobacco use and number of ADHD symptoms can influence adolescents’ perceptions of e-cigarettes and their e-cigarette use. Adolescents with ADHD (n = 80) completed questionnaires assessing parental messages about tobacco use; e-cigarette harm perceptions; susceptibility to use e-cigarettes; and e-cigarette use. Parents reported on messages about tobacco use, adolescent’s ADHD symptomatology, and completed demographic questionnaires. Twenty-percent of adolescents reported e-cigarette ever use. Adolescent girls were significantly more likely to report higher e-cigarette harm perceptions than boys. Parents reported providing messages …

Understanding Predictors Of Telemedicine Adoption Before, During, And After The Covid-19 Pandemic, Bradford S. Pierce

Theses and Dissertations

This study examined change in physicians’ use of telemedicine before, during, and expectations after the COVID-19 pandemic. It also examined the ability of personal and environmental variables to predict telemedicine adoption, and applied the theory of reasoned action and technology acceptance model to physicians’ adoption of telemedicine during the pandemic. A total of 230 licensed physicians currently practicing in the United States were recruited. Telemedicine accounted for 3.72% of physicians’ clinical work prior to the pandemic, 46.03% during the pandemic, and predicted 25.44% after the pandemic ends. Physicians within hospitals reported less telemedicine use during the pandemic (M = …

Evaluating The Effects Of Electronic Nicotine Delivery Systems On Smoking Reduction, Negative Mood, And Stress Among Smokers With Mental Illness, Cosima Hoetger

Theses and Dissertations

Introduction: Smokers with mental illness (MI) are disproportionately affected by negative health outcomes. Electronic nicotine delivery systems (ENDS) may represent a harm reduction tool for those who reduce and/or replace their cigarettes with ENDS. Little previous research has examined how smokers with MI respond to ENDS. This analysis aimed to address this research gap using secondary data from a randomized controlled trial of ENDS varying in nicotine delivery among smokers with and without current MI. The aims were to test 1) the effects of MI status, condition, and time on changes in smoking behavior and negative mood and stress measures, …

Physiological And Subjective Effects Of Protonated Nicotine Liquids In Tobacco Users, Alisha Eversole

Theses and Dissertations

Electronic cigarettes (ECIGs) produce an aerosol by heating a liquid that often contains nicotine. The nicotine can be protonated, potentially making the aerosol easier to inhale than freebase nicotine. This study’s purpose was to determine, in inhaled tobacco product users, the effects of three concentrations of protonated nicotine aerosolized at two different power settings (in watts).

Twenty-two participants completed six sessions that varied by liquid nicotine concentration (10, 15, or 30 mg/ml protonated nicotine) and device power (15 or 30 W). Participants took 10 puffs from each product and then used each product for 60 minutes ad libitum. Plasma …

The Impact Of Healthcare Professional Students' Racial, Hiv-Related, And Abortion-Related Biases On Recommendations For Prenatal Care, Alison J. Patev

Theses and Dissertations

Black women and HIV-positive women have increased maternal mortality rates and other negative pregnancy outcomes, in part due to disparate prenatal care. Although women who seek abortions do not have the same negative outcomes, abortion stigma exists and is normalized in healthcare. Limited work has examined prenatal care provision for women in these groups, and even less work has explored the prenatal care provision by healthcare trainees (i.e., medical, nurse practitioner, and physician assistant students). Examining the role of bias on the prioritization of prenatal care items by healthcare trainees is imperative. Healthcare education sets the stage for future practice, …

The Harm In Seeking Care: Assessing The Relationship Between Healthcare Discrimination And Healthcare Avoidance Behaviors In The Past Year And Since The Start Of The Coronavirus Pandemic In A Transgender And Gender Independent Sample, Kyle L. Mason

Theses and Dissertations

Background: Gender minorities encounter a myriad of barriers to accessing general and gender affirming healthcare. Financial disparities impacting affordability of healthcare costs and insurance-based denials for gender-affirming care are among prominent barriers discussed. Considerations of the prevalence of stigma, discrimination, and erasure of gender minority identities must not be neglected when seeking to understand healthcare accessibility and utilization in this population. Previous researchers have examined gender minority patients’ experiences of discrimination in healthcare settings and delaying care due to fear of discrimination. There is a dearth of knowledge about the relationship between lifetime exposure to varied forms of healthcare discrimination …